RHINOVIRUS INFECTION OF THE NORMAL HUMAN AIRWAY

Selected events in rhinovirus infection of the normal human airway can be regarded as occurring sequentially. Initial steps in rhinovirus pa thogenesis are believed to include viral entry into the nose, mucocili ary transport of virus to the posterior pharynx, and initiation of inf ection in ciliated and nonciliated epithelial cells of the upper airwa y. Viral replication peaks on average within 48 h of initiation of inf ection and persists for up to 3 wk. Infection is followed by activatio n of several inflammatory mechanisms, which may include release or gen eration of interleukins, bradykinins, prostaglandins, and possibly his tamine and stimulation of parasympathetic reflexes. Pathophysiologic p rocesses are initiated, which include vasodilatation of nasal blood ve ssels, transudation of plasma, glandular secretion, and stimulation of nerve fibers, causing pain and triggering sneeze and cough reflexes. The resultant clinical illness is a rhinosinusitis, pharyngitis, and b ronchitis, which, on average, lasts 1 wk.